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  4. Cough-induced hemiparesis: an unusual manifestation of cord compression

Cough-induced hemiparesis: an unusual manifestation of cord compression

BMJ Case Rep, 2016 · DOI: 10.1136/bcr-2016-215537 · Published: May 12, 2016

Spinal Cord InjuryNeurologyResearch Methodology & Design

Simple Explanation

A 67-year-old woman experienced recurrent episodes of left arm and leg weakness and numbness triggered by coughing or sneezing. X-rays revealed an enlarged space and narrowed spinal canal in her cervical spine, indicating atlantoaxial instability. MRI scans confirmed spinal cord compression, particularly on the left side, explaining her symptoms.

Study Duration
1 year history of recurrent episodes
Participants
A 67-year-old woman
Evidence Level
Level 4: Case Report

Key Findings

  • 1
    Atlantoaxial instability can cause spinal cord compression, leading to transient neurological symptoms.
  • 2
    Coughing or sneezing can precipitate hemiparesis in patients with cord compression.
  • 3
    MRI can reveal hemicord edema, correlating with the side of neurological symptoms.

Research Summary

This case report describes a 67-year-old woman with recurrent episodes of cough-induced hemiparesis due to atlantoaxial instability and spinal cord compression. The patient's symptoms were triggered by coughing or sneezing and involved left arm and leg weakness and numbness. Following C1/2 vertebral fusion, the patient has remained asymptomatic.

Practical Implications

Diagnostic Consideration

Consider cord compression in patients presenting with transient neurological symptoms precipitated by head movements or coughing.

Imaging Importance

Utilize cervical spine X-rays and MRI to assess for atlantoaxial instability and spinal cord compression.

Surgical Intervention

Vertebral fusion may be a successful treatment for atlantoaxial instability causing cord compression.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of long-term follow-up data.
  • 3
    Specific to cough-induced symptoms.

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